Lion of the Blogosphere

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Lion was dead-on right about predicted Covid-19 deaths

On August 24, I wrote:

We keep getting worse and worse at social distancing, we are sending kids back to school, a new wave of cases before we get a vaccine seems kind of inevitable. I predict between 400,000 and 800,000 U.S. deaths from Covid-19 before the pandemic is ended with a vaccine.

We have now passed 400,000 officially tallied deaths (although excess deaths are higher than that so one can argue that the real number of deaths from Covid-19 is higher), so my prediction is proven true.

Let’s review some comments I received to that post in August.

“jg” wrote:

Thank you for sticking to a quite high 400k+ US additional death prediction, which I expect will fail.

Sorry, I was right, you were wrong.

“destructure” wrote

Why do you have to be so negative? Do you suffer depression or something?

So it’s mental illness to accurately predict the future? The world needs more mentally ill people.

“Seingalt” wrote:

Lion i think you completely lost the plot. Have you noticed that in countries such as Italy the virus is killing almost no one and the intensive care units are empty?

As I pointed out back then, Italy was benefitting from stricter enforced social distancing than we were in the United States.

Also, there were a lot of comments about Cuomo. Trump supporters HATE Cuomo because Cuomo was extremely good at communicating about the pandemic and thus was widely lauded, while Trump sucked at everything to do about the pandemic. I’ll repeat what I said before:

Trump supporters think Covid-19 is a lot of bullshit. Except for when Cuomo required nursing homes to take back medically stable Covid-19 patients. In that one, and only one, scenario, Covid-19 is a Very Serious Disease.

Written by Lion of the Blogosphere

January 21, 2021 at 12:13 PM

Covid-19 November update

Back in August I wrote:

We keep getting worse and worse at social distancing, we are sending kids back to school, a new wave of cases before we get a vaccine seems kind of inevitable. I predict between 400,000 and 800,000 U.S. deaths from Covid-19 before the pandemic is ended with a vaccine.

My prediction continues to be on target. The last update from the Covid Tracking Project is that we have record number hospitalized and record cases in one day, and if the trend continues this will keep getting worse. We already have 233,000+ deaths.

We are heading into Thanksgiving, and unless the government shuts down all the roads to prevent people from going places on Thanksgiving (and we lack the political will to do that), Thanksgiving will cause a major spike at a time when the virus is already out of control.

Trump insisted we are “rounding the corner” and that the media will stop reporting on Covid-19 as soon as the election is over. Trump is being proved horrible wrong. We are not rounding a corner, we are in slow-motion heading into a huge collision.

It’s also obvious that eventually Covid-19 will be so bad we will say “oh shit, this is bad, we have to change our behavior” and state governments will start closing stuff, but we lack the wisdom to close stuff BEFORE it gets like that, thus we condemn a few hundred thousand to unnecessary deaths because we are too stupid to do the right thing at the right time.

Written by Lion of the Blogosphere

November 12, 2020 at 5:17 PM

The truth comes out, political correctness overrules real science

From a New York Times article:

When the coronavirus emerged in China in January, the World Health Organization didn’t flinch in its advice: Do not restrict travel.

But what is now clear is that the policy was about politics and economics more than public health.

Public health records, scores of scientific studies and interviews with more than two dozen experts show the policy of unobstructed travel was never based on hard science. It was a political decision, recast as health advice, which emerged after a plague outbreak in India in the 1990s. By the time Covid-19 surfaced, it had become an article of faith.

“It’s part of the religion of global health: Travel and trade restrictions are bad,” said Lawrence O. Gostin, a professor of global health law at Georgetown University who helped write the global rules known as the International Health Regulations. “I’m one of the congregants.”

So we see, the mantra against not restricting travel is a combination of political correctness (don’t stigmatize non-white countries) and business interests (don’t harm the profitability of airlines and the tourism industry).

Written by Lion of the Blogosphere

September 30, 2020 at 12:16 PM

Excess deaths outstrip official Covid-19 deaths

For people who don’t read my tweets:

Written by Lion of the Blogosphere

September 3, 2020 at 9:21 AM

The current state of Covid-19 in the U.S.

Back in May, I did an estimate of how many would die in each age group, based on what happened in New York City, if we would just let the virus infect everyone without doing any social distancing. I stand by that as the theoretical scenario that probably couldn’t have happened because it’s simply not possible that everyone would just ignore the pandemic and carry on as if nothing was happening.

In the real world, the explosion of virus cases in New York City resulted in social distancing, both government mandated and voluntary. This social distancing has lowered the transmission rate.

I believe that there are two other factors at play keeping total deaths down.

(1) After a certain percentage of the population in a geographic area gets the virus, we see transmission rates drop. That happened most dramatically in the New York City metropolitan area which now has the fewest new cases of any large metropolitan area in the United States. But it also helps that Andrew Cuomo is taking the virus seriously and not allowing restaurants and bars to re-open.

It has been suggested that a certain percentage of the population already had partial resistance to Covid-19 because they previously had common-cold coronaviruses. I think there is merit to this theory, and helps explain why the transmission rates drop faster than expected.

The population isn’t homogeneous in their behavior. We can divide the population roughly into two groups. Group A, which is bad at social distancing (because they are essential workers or because they are just irresponsible people) have had a high percentage infected and transmission rates have dropped in this group even though they continue to be bad at social distancing. And then there is Group B, the good social distancers. We are working from home and not going out to restaurants or going to parties, and our group has a much lower rate of infected. If we were all suddenly to go back to behaving exactly how we behaved before the pandemic, this group would see a new mass wave of infections. The virus would literally go viral among us.

The bottom line here is that we do NOT have herd immunity. In New York City, we still have 200+ new cases every day, and we have a Group B that is relatively unexposed to the virus compared to Group A. Herd immunity only happens from a vaccine and we do not yet have a vaccine. And even when it comes, I’m pessimistic about how good of a job we will do making sure that everyone gets vaccinated. We have managed to fuck up everything else about responding to the pandemic.

(2) I have come across the theory that social distancing doesn’t just lower the transmission rate, it also lowers the average severity of infections. How sick you get is partially a function of how much initial viral load you pick up. Because of social distancing, people who do get infected are getting infected with a lower initial viral load so their illness isn’t as severe. This could help explain why the lethality of Covid-19 seems to have dropped since March.

When dumb conservatives and virus denier types say that “only” 176,000 have died from the virus (a number which still keeps going up every day) and therefore the virus isn’t a big deal and we overreacted, they are ignoring the fact that the only reason it’s 176,000 and not 1,760,000 is because Americans changed their behavior in response to the pandemic. We don’t change our behavior in response to the flu. That’s why, so far, the pandemic is “only” three times worse than a bad flu season based on total deaths attributed to flu and to Covid-19.

Despite how bad of job we are doing in response to the pandemic, the worst-case estimate from my post in May isn’t very likely to happen. But more will definitely die before it’s over. We keep getting worse and worse at social distancing, we are sending kids back to school, a new wave of cases before we get a vaccine seems kind of inevitable. I predict between 400,000 and 800,000 U.S. deaths from Covid-19 before the pandemic is ended with a vaccine. That’s between one-sixth and one-third of the worst-case estimates from my post in May.

Written by Lion of the Blogosphere

August 24, 2020 at 5:21 PM

Do Haredi Jews in NYC have (temporary) herd immunity?

Frequent commenter Yakov reports that the Haredi Jews in NYC are ignoring social distancing yet no one’s getting sick. At least not this month.

Back in April the NY Times reported that the Haredi community was hit vey hard and there had been 700 deaths. That’s actually quite a low number considering there are something like a quarter of a million Haredi in Brooklyn. If there had been a 1% fatality rate, there should be 2,500 dead Haredi.

However, the Haredi population is very young because they have massive numbers of children, and we know that the fatality rate is a lot lower for the young than the old.

Additionally, 700 could be an undercount, and furthermore people were still dying when this article was written and there were surely more deaths since then.

Epidemiologists should study the Haredi community to learn about what would happen if we refuse to do social distancing and just let everyone get infected.

* * *

The Haredi were probably responsible for contributing to the spread of the virus outside of their community.

Written by Lion of the Blogosphere

July 16, 2020 at 2:29 PM

The virus is a big deal

One of the big deficiencies of pandemic reporting is the failure to report things by age groups. Back in May I did a ballpark estimate of the IFR by age group, and given the lack of anything better, I think my estimates are pretty good.

During the current spike in cases, Republicans have been insisting that the virus is no longer a problem because deaths have been trending down. (Except this is wrong with respect to the most recent week because deaths are now going up in places where cases started increasing a few weeks ago.)

One thing that has been reported is that younger people have been a disproportionate percent of cases during this second wave of cases. Because people between the ages of 18 and 44 have only a 0.1% infected fatality rate (although the case fatality rate would be higher than that), this would be an important factor in explaining the immediate lack of deaths corresponding to the rising number of cases. (The other important factor is it takes weeks before a reported case turns into a reported death. Cases today predict deaths in the future.)

But it doesn’t mean the virus isn’t a big deal because younger people are getting infected.

(1) If large numbers of young people are infected, they will spread it to older people.

(2) it’s wrong to think of the virus in terms of a binary live or die situation. There is evidence that many people who caught the virus and survive will suffer continuing health consequences. I list again some of the known health consequences: permanent loss of smell, blood clotting (leading to dangerous strokes), heart damage, permanently reduced lung capacity, chronic fatigue syndrome, multi-system inflammatory syndrome. What percent of people will have continuing health problems? I don’t know, but better safe than sorry, because optimism about this virus has been proven wrong over and over again.

(3) The number of people who need to be hospitalized exceeds the number of people who die. What happens to people who need to be hospitalized, but because of a huge surge in cases the hospitals are full? The answer is that the case fatality rate increases when this happens. Furthermore, what happens to people who need hospitalization for other reasons when the hospitals are full? Hospitals full to capacity with Covid-19 patients is a huge public health crisis independent of the fatality rate for people who get good care.

Written by Lion of the Blogosphere

July 15, 2020 at 1:43 PM

Some pessimism about the pandemic

Some may ask, “hasn’t your blog been pessimistic enough about the pandemic?” And the answer is no, I’ve only been realistic.

So here’s some pessimism to consider:

(1) Immunity to the virus only lasts a few months. This means that the optimistic view, that people getting sick and dying from the virus is, at least, for the greater good of herd immunity, is wrong. There will never be natural herd immunity to Covid-19 because after a few months people can catch it again. Those who got sick and those who died, they did so for no benefit to society. They are just victims of our nation’s dysfunctional response to a health crisis.

(2) The virus isn’t a binary case of either you have a mild case and it’s a “nothingburger” (as some delusional commenters say), or you die but that only happens if you are really old and old people deserve to die anyway. There’s a lot of unknowns, but the pessimistic viewpoint would be that a pretty significant number of people who had the virus and didn’t die from it directly will suffer long-term health problems which may later prove to be fatal. Some of these health consequences include blood clotting and strokes, heart damage, lung damage, permanent loss of smell, chronic fatigue syndrome, multi-system inflammatory syndrome.

(3) There’s no magical end to the pandemic other than a vaccine. That’s not pessimism, that’s just realism. But the pessimistic outlook on vaccines is that you won’t get vaccinated as soon as you would like, not going to happen until a year from now at least. And when you do get vaccinated, it will only give you immunity for a few months and then it will go away. If that. The only way for the vaccine to be effective is if everyone, and I mean everyone, gets it, and gets it again at regular intervals. While other more competent countries will be able to handle that, will the dysfunctional United States have the political will to require vaccinations, like it or not?

(4) Given that the virus will be endemic and only controlled by vaccines rather than eliminated, social distancing will never entirely end, we will never return to life exactly the way it was before. Crowded cities with crowded office buildings and crowded bars and restaurants and crowded public transportation won’t make sense. Cruise ships won’t make sense. College students living in dorms (and other communal living situations) won’t make sense. The economic disruptions will be huge and ongoing. There’s certainly not going to be a “v-shaped” recovery.

Written by Lion of the Blogosphere

July 14, 2020 at 9:03 AM

Schools and the virus

I tweeted that yesterday.

Today it occurred to me that the push to re-open schools is an unholy alliance between Trumpists who deny that the virus is harmful and insist that it’s a global conspiracy to get Biden elected, so they want schools to open in order to boost the economy and Trump’s chances of winning reelection, and between leftist types who are more worried about the “gap” than they are about doing the right thing for the majority of the people in order to close the “gap” (which can’t be closed because of HBD).

Although there is strong evidence that children are less likely to catch and spread the virus than adults (and also that seniors are more likely to catch and spread the virus than younger adults, which is why the virus spreads so easily though nursing homes), and there are less likely to be outbreaks at schools than at adult work places, nevertheless, there have been outbreaks at schools in Israel. And there are teachers who caught the virus at summer school in Arizona. There have been outbreaks at youth camps. So outbreaks at schools can definitely happen, and surely will happen if we just reopen schools the way they were before the pandemic.

Some may argue it’s no big deal if children catch the virus at school because they rarely get sick from it. There are two problems with this argument. (1) We don’t fully know to what extent children’s long-term health could be impacted by the virus. It’s known that a small number of children get a serious condition they call multi-inflammatory syndrome after being exposed to the virus. (2) Children who catch the virus at school will go home and spread it to their parents who are at more risk. Even though children may not be as contagious as adults, let’s use some common sense. People living in the same household are going to catch it because of the large amount of time spent in close contact with each other. And this is true even if the point of entry into the household is a child. I’ve read that children shed half as much virus as adults, but that’s enough virus to spread it to adults in the same household.

With such a huge amount of virus in the United States, it’s not wise to open schools right now. In other countries, where the virus is more under control and the people act more responsibly and they have uniform national guidelines that are followed, those other countries are in much better shape to open schools than we are in the United States. Let’s let other countries do it first and learn from them.

Written by Lion of the Blogosphere

July 13, 2020 at 1:35 PM

The slow-motion trainwreck

I can’t write about the pandemic without writing about how horrible Trump is. This is important for the audience of people who read this blog, because most of the readers are Trump supporters. I voted for Trump (but won’t make that mistake again). I was excited as anyone when he beat Hillary. Even though by the time of the election, I already know that Trump was full of shit on a lot of things and he didn’t even understand his own policy platform. I knew that Mexico was never going to pay for the Wall, but I was optimistic that the Wall would be built anyway. (Of course, no Wall was built.)

Maybe Trump is going senile. I hope he’s going senile because that would excuse me for voting for him. How could I have known in 2016 that he was going senile and was no longer the same person who he was when he was younger? If that’s really what’s happening.

Back in 2016, I was optimistic that Trump would become more Presidential once he actually became President. I can’t say that ever really happened, but during the last year especially he has declined into being even less Presidential than he was when he was running for office back in 2016. So maybe the senility explanation will hold up. Or maybe it’s just a Trump personality flaw that he retreats into bozoness when faced with adversity, and there has been a lot of adversity for Trump during the last year.

Maybe, if we are lucky, Tucker Carlson, one of the few smart people who understands and supports what a Trumpist national policy actually means, will run for President in 2024 and win. But that’s a real longshot.

But regardless, you Trump supporters need to STOP believing what Trump says and stop repeating his stupid talking points which have become more and more divorced from reality. Clearly, Trump is not able to process the reality of the pandemic. Trump supporters make excuses for Trump saying that the virus was a hoax, but it’s pretty clear that Trump truly believes that the virus is a fake narrative was made up by his enemies and the virus would go away if we just stopped paying attention to it.

How else do you explain Trump’s intentional sabotaging of our efforts to control the virus? Encouraging people to protest the shutdowns, encouraging people not to wear masks or socially distance, preventing the federal government from actually doing anything useful to coordinate our response to the pandemic, leaving it up to the governors of the 50 states, with each state doing its own thing.

The latest Trump talking point that this followers are repeating is that deaths have been going down, therefore everything is good and under control and we don’t have to do anything. To the extent that deaths have been declining because we have better treatments for the virus than we had back in March, that’s great, but it’s a dangerous assumption to make that that’s the only thing that’s happening and treatments will continue to get so much better that we can stop worrying about the pandemic.

The two major reasons why deaths have been declining despite rising cases (other than better treatments) are:

(1) Deaths are a lagging indicator. It takes a week before an infection because a reported case, and then another four weeks before a reported cased becomes a reported death. Thus the increase in cases that began in mid June haven’t had enough time to cause a large increase in reported deaths. Furthermore, because actual infections lag reported cases, and because infections increase at a geometric rate and not a linear rate, there could a big wave of infections that haven’t been reported yet as cases. So I have no doubt that an increase in deaths will come.

(2) The latest cases have been disproportionately young people because they have been the ones who have been going to bars and parties and protests. We know that young people have a much lower fatality rate than older people. But this doesn’t mean we can relax. Infected young people are still contagious and they will infect their older family members and “essential” workers. Also, it’s not yet clear that young people suffer no consequences from a mild case of the virus. It could be that a worrisome percentage of people, even young people, with mild cases of the virus could have longterm health consequences. The medical community is still learning about this virus.

Right now, the U.S. looks like a slow-motion train wreck. States with rising numbers of cases are shutting some things down, but I don’t think enough things are shutting down to lower the R0 below 1, which means that infections will still increase and hospitals will become full and there won’t be enough resources to treat everyone who’s sick, and not only will the fatality rate for the virus increase, but people will die from other causes because emergency healthcare won’t be available for them. Eventually there will be an “oh shit” moment and strict lockdowns will be instituted, which means we will be back to where we were in March, the last three months totally wasted, while in other countries they have gotten the virus under control and are able to SAFELY open up the economy because they have few cases plus robust contact tracing.

And about contact tracing: the U.S. also sucks at that. A combination of a “diverse” population that doesn’t voluntarily comply, and a lack of political will to get tough and make people comply.

* * *

Apparently, another totally false Trump talking point that needs to be addressed is that the only reason there are a lot of cases in the U.S. is that we are doing a lot of testing.

Scott Gottlieb, former Commissioner of the FDA (appointed by Trump) shows that’s totally false:

Written by Lion of the Blogosphere

July 7, 2020 at 11:43 AM

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